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Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Beacon Protocols,GU

CSC GU Interferon Alfa-2B(28D:3xWeekly) Self-Administered VER 12-1-16 (HL 745)

CSC GU Interferon Alfa-2B(28D:3xWeekly) Self-Administered VER 12-1-16 (HL 745) - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Beacon Protocols, GU


CSC GU INTERFERON ALFA-2B(28D:3XWEEKLY) SELF-ADMINISTERED VER: 12-1-16 (HL 745) – Properties
Pre-Cycle – 6/8/2017 through 6/14/2017 (7 days), Planned
Day 1, Pre-Cycle – Planned for 6/8/2017
Treatment Plan Information
Treatment Plan Summary
DISEASE: Renal Cancer (Adjuvant/Advanced); THERAPY: interferon alfa-2B 5 to 10 million units/m2 subcutaneous 3 times per
week; CYCLE LENGTH: 28 days; COURSE: 6 cycles or until disease progression.
Consent
Verify Consent
Verify informed consent has been obtained.
Pre-Labs
CBC WITHOUT DIFFERENTIAL
Expected-S Approximate, Expires-S+365, Routine
ABSOLUTE NEUTROPHIL COUNT
Expected-S Approximate, Expires-S+365, Routine
CREATININE
Expected-S Approximate, Expires-S+365, Routine
Take Home Medications
acetaMINOPHEN (TYLENOL) 325 MG tab
Take 1-2 tabs by mouth every 4 hours as needed for fever or pain., 325-650 mg, Disp-100 tab, R-6, EVERY 4 HOURS PRN
starting S
ondansetron (ZOFRAN) 8 MG tab
Take 1 tab by mouth every 8 hours as needed for nausea/vomiting., 8 mg, Disp-30 tab, R-5, EVERY 8 HOURS PRN starting S,
Local Printer
Cycle 1 – 6/15/2017 through 7/12/2017 (28 days), Planned
Day 1, Cycle 1 – Planned for 6/15/2017
Treatment Plan Information
Reference Information (1)
RENAL CANCER: Quesada JR, et al. J Clin Oncol 1985;3:1522-8.
Reference Information (2)
RENAL CANCER: Muss HB, et al. J Clin Oncol 1987;5:286-91.
Reference Information (3)
RENAL CANCER: Flanigan RC, et al. N Engl J Med 2001;345:1655-9
Reference Information (4)
RENAL CANCER: Mickisch GHJ, et al. Lancet 2001;358:966-70.
Treatment Plan Summary
DISEASE: Renal Cancer (Adjuvant/Advanced); THERAPY: interferon alfa-2B 5 to 10 million units/m2 subcutaneous 3 times per
week; CYCLE LENGTH: 28 days; COURSE: 6 cycles or until disease progression.
Consent
Verify Consent
Verify informed consent has been obtained.
IV Access
Insert and Maintain Peripheral IV
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Zztestonc,Jeff J [2507481]
6/15/2017 7:59:44 AM Page 1 of 9
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
06/2017CCKM@uwhealth.org

CONTINUOUS Starting when released Until Specified
Peripheral IV Size: RN Discretion
Additional PIV may be inserted as needed for repeat blood sampling or IV medication administration.
Treatment Conditions
Verify Labs
Verify pretreatment labs have been obtained: CBC, ANC.
Treatment Parameters
Hold and notify authorizing prescriber for ANC less than or equal to 1,000/µL or Platelets less than or equal to 75K/µL.
Nursing Procedure, Assessment and Monitoring
Patient Instructions(1)
Teach patient how to self-administer a subcutaneous injection.
Pre-Medications
acetaMINOPHEN (TYLENOL) tab 650 mg
650 mg, Oral, ONCE, 1 dose Starting when released
Administer 30 minutes prior to chemotherapy. No more than 4 grams acetaminophen per 24 hours for adults or 15mg/kg per dose
for peds <40kg.
ondansetron (ZOFRAN) tab 8 mg
8 mg, Oral, ONCE, 1 dose Starting when released
Give prior to chemotherapy.
Treatment Medications
interferon alfa-2B (INTRON A) vial 20 Million Units
20 Million Units (rounded from 19.6 Million Units = 10 Million Units/m2 × 1.96 m2 Treatment plan BSA from recorded weight),
Subcutaneous, ONCE, 1 dose Starting when released
Use patients Take Home Medication supply. Corticosteriods are NOT allowed for routine use.
See Take Home Medication(s)
Refer to the take home medications section on Day 1 for the following treatment medication(s): interferon alfa-2B
Take Home Medications
interferon alfa-2B (INTRON A) 50000000 UNITS injection
Inject under skin 3 times per week., R-6, 3 X WEEKLY starting S
Follow-Up
DAY 15 FOLLOW-UP
LABS: CBC, ANC (DIFF if done locally).
DAY 29 FOLLOW-UP
(Day 1 of next cycle) RETURN TO CLINIC for appointment with provider; LABS: CBC, ANC (DIFF if done locally), Creatinine;
CHEMOTHERAPY ROOM appointment for interferon alfa-2B SC injection for 30 minutes.
Lab Only - Day 15, Cycle 1 – Planned for 6/29/2017
Treatment Plan Information
Treatment Plan Summary
DISEASE: Renal Cancer (Adjuvant/Advanced); THERAPY: interferon alfa-2B 5 to 10 million units/m2 subcutaneous 3 times per
week; CYCLE LENGTH: 28 days; COURSE: 6 cycles or until disease progression.
IV Access
Insert and Maintain Peripheral IV
CONTINUOUS Starting when released Until Specified
Peripheral IV Size: RN Discretion
Additional PIV may be inserted as needed for repeat blood sampling or IV medication administration.
Pre-Labs
CBC WITHOUT DIFFERENTIAL
Expected-S+14 Approximate, Expires-S+365, Routine
ABSOLUTE NEUTROPHIL COUNT
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Zztestonc,Jeff J [2507481]
6/15/2017 7:59:44 AM Page 2 of 9
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
06/2017CCKM@uwhealth.org

Expected-S+14 Approximate, Expires-S+365, Routine
Follow-Up
VERIFY APPOINTMENTS
Verify next day appointment(s) have been scheduled. See follow-up section on Day 1.
Cycle 2 – 7/13/2017 through 8/9/2017 (28 days), Planned
Day 1, Cycle 2 – Planned for 7/13/2017
Treatment Plan Information
Reference Information (1)
RENAL CANCER: Quesada JR, et al. J Clin Oncol 1985;3:1522-8.
Reference Information (2)
RENAL CANCER: Muss HB, et al. J Clin Oncol 1987;5:286-91.
Reference Information (3)
RENAL CANCER: Flanigan RC, et al. N Engl J Med 2001;345:1655-9
Reference Information (4)
RENAL CANCER: Mickisch GHJ, et al. Lancet 2001;358:966-70.
Treatment Plan Summary
DISEASE: Renal Cancer (Adjuvant/Advanced); THERAPY: interferon alfa-2B 5 to 10 million units/m2 subcutaneous 3 times per
week; CYCLE LENGTH: 28 days; COURSE: 6 cycles or until disease progression.
Consent
Verify Consent
Verify informed consent has been obtained.
IV Access
Insert and Maintain Peripheral IV
CONTINUOUS Starting when released Until Specified
Peripheral IV Size: RN Discretion
Additional PIV may be inserted as needed for repeat blood sampling or IV medication administration.
Pre-Labs
CBC WITHOUT DIFFERENTIAL
Expected-S+28 Approximate, Expires-S+365, Routine
ABSOLUTE NEUTROPHIL COUNT
Expected-S+28 Approximate, Expires-S+365, Routine
CREATININE
Expected-S+28 Approximate, Expires-S+365, Routine
Treatment Conditions
Verify Labs
Verify pretreatment labs have been obtained: CBC, ANC.
Treatment Parameters
Hold and notify authorizing prescriber for ANC less than or equal to 1,000/µL or Platelets less than or equal to 75K/µL.
Nursing Procedure, Assessment and Monitoring
Patient Instructions
Educated/reinforce patient training in subcutaneous self-administration technique. Confirm patient has an adequate supply of
interferon for the next cycle of therapy.
Follow-Up
DAY 15 FOLLOW-UP
LABS: CBC, ANC (DIFF if done locally).
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Zztestonc,Jeff J [2507481]
6/15/2017 7:59:44 AM Page 3 of 9
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
06/2017CCKM@uwhealth.org

DAY 29 FOLLOW-UP
(Day 1 of next cycle) RETURN TO CLINIC for appointment with provider; LABS: CBC, ANC (DIFF if done locally),
Creatinine; CHEMOTHERAPY ROOM appointment for interferon alfa-2B SC injection for 30 minutes.
Lab Only - Day 15, Cycle 2 – Planned for 7/27/2017
Treatment Plan Information
Treatment Plan Summary
DISEASE: Renal Cancer (Adjuvant/Advanced); THERAPY: interferon alfa-2B 5 to 10 million units/m2 subcutaneous 3 times per
week; CYCLE LENGTH: 28 days; COURSE: 6 cycles or until disease progression.
IV Access
Insert and Maintain Peripheral IV
CONTINUOUS Starting when released Until Specified
Peripheral IV Size: RN Discretion
Additional PIV may be inserted as needed for repeat blood sampling or IV medication administration.
Pre-Labs
CBC WITHOUT DIFFERENTIAL
Expected-S+14 Approximate, Expires-S+365, Routine
ABSOLUTE NEUTROPHIL COUNT
Expected-S+14 Approximate, Expires-S+365, Routine
Follow-Up
VERIFY APPOINTMENTS
Verify next day appointment(s) have been scheduled. See follow-up section on Day 1.
Cycle 3 – 8/10/2017 through 9/6/2017 (28 days), Planned
Day 1, Cycle 3 – Planned for 8/10/2017
Treatment Plan Information
Reference Information (1)
RENAL CANCER: Quesada JR, et al. J Clin Oncol 1985;3:1522-8.
Reference Information (2)
RENAL CANCER: Muss HB, et al. J Clin Oncol 1987;5:286-91.
Reference Information (3)
RENAL CANCER: Flanigan RC, et al. N Engl J Med 2001;345:1655-9
Reference Information (4)
RENAL CANCER: Mickisch GHJ, et al. Lancet 2001;358:966-70.
Treatment Plan Summary
DISEASE: Renal Cancer (Adjuvant/Advanced); THERAPY: interferon alfa-2B 5 to 10 million units/m2 subcutaneous 3 times per
week; CYCLE LENGTH: 28 days; COURSE: 6 cycles or until disease progression.
Consent
Verify Consent
Verify informed consent has been obtained.
IV Access
Insert and Maintain Peripheral IV
CONTINUOUS Starting when released Until Specified
Peripheral IV Size: RN Discretion
Additional PIV may be inserted as needed for repeat blood sampling or IV medication administration.
Pre-Labs
CBC WITHOUT DIFFERENTIAL
Expected-S+28 Approximate, Expires-S+365, Routine
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Zztestonc,Jeff J [2507481]
6/15/2017 7:59:44 AM Page 4 of 9
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
06/2017CCKM@uwhealth.org

ABSOLUTE NEUTROPHIL COUNT
Expected-S+28 Approximate, Expires-S+365, Routine
CREATININE
Expected-S+28 Approximate, Expires-S+365, Routine
Treatment Conditions
Verify Labs
Verify pretreatment labs have been obtained: CBC, ANC.
Treatment Parameters
Hold and notify authorizing prescriber for ANC less than or equal to 1,000/µL or Platelets less than or equal to 75K/µL.
Nursing Procedure, Assessment and Monitoring
Patient Instructions
Educated/reinforce patient training in subcutaneous self-administration technique. Confirm patient has an adequate supply of
interferon for the next cycle of therapy.
Follow-Up
DAY 15 FOLLOW-UP
LABS: CBC, ANC (DIFF if done locally).
DAY 29 FOLLOW-UP
(Day 1 of next cycle) RETURN TO CLINIC for appointment with provider; LABS: CBC, ANC (DIFF if done locally), Creatinine;
CHEMOTHERAPY ROOM appointment for interferon alfa-2B SC injection for 30 minutes.
Lab Only - Day 15, Cycle 3 – Planned for 8/24/2017
Treatment Plan Information
Treatment Plan Summary
DISEASE: Renal Cancer (Adjuvant/Advanced); THERAPY: interferon alfa-2B 5 to 10 million units/m2 subcutaneous 3 times per
week; CYCLE LENGTH: 28 days; COURSE: 6 cycles or until disease progression.
IV Access
Insert and Maintain Peripheral IV
CONTINUOUS Starting when released Until Specified
Peripheral IV Size: RN Discretion
Additional PIV may be inserted as needed for repeat blood sampling or IV medication administration.
Pre-Labs
CBC WITHOUT DIFFERENTIAL
Expected-S+14 Approximate, Expires-S+365, Routine
ABSOLUTE NEUTROPHIL COUNT
Expected-S+14 Approximate, Expires-S+365, Routine
Follow-Up
VERIFY APPOINTMENTS
Verify next day appointment(s) have been scheduled. See follow-up section on Day 1.
Cycle 4 – 9/7/2017 through 10/4/2017 (28 days), Planned
Day 1, Cycle 4 – Planned for 9/7/2017
Treatment Plan Information
Reference Information (1)
RENAL CANCER: Quesada JR, et al. J Clin Oncol 1985;3:1522-8.
Reference Information (2)
RENAL CANCER: Muss HB, et al. J Clin Oncol 1987;5:286-91.
Reference Information (3)
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Zztestonc,Jeff J [2507481]
6/15/2017 7:59:44 AM Page 5 of 9
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
06/2017CCKM@uwhealth.org

RENAL CANCER: Flanigan RC, et al. N Engl J Med 2001;345:1655-9
Reference Information (4)
RENAL CANCER: Mickisch GHJ, et al. Lancet 2001;358:966-70.
Treatment Plan Summary
DISEASE: Renal Cancer (Adjuvant/Advanced); THERAPY: interferon alfa-2B 5 to 10 million units/m2 subcutaneous 3 times per
week; CYCLE LENGTH: 28 days; COURSE: 6 cycles or until disease progression.
Consent
Verify Consent
Verify informed consent has been obtained.
IV Access
Insert and Maintain Peripheral IV
CONTINUOUS Starting when released Until Specified
Peripheral IV Size: RN Discretion
Additional PIV may be inserted as needed for repeat blood sampling or IV medication administration.
Pre-Labs
CBC WITHOUT DIFFERENTIAL
Expected-S+28 Approximate, Expires-S+365, Routine
ABSOLUTE NEUTROPHIL COUNT
Expected-S+28 Approximate, Expires-S+365, Routine
CREATININE
Expected-S+28 Approximate, Expires-S+365, Routine
Treatment Conditions
Verify Labs
Verify pretreatment labs have been obtained: CBC, ANC.
Treatment Parameters
Hold and notify authorizing prescriber for ANC less than or equal to 1,000/µL or Platelets less than or equal to 75K/µL.
Nursing Procedure, Assessment and Monitoring
Patient Instructions
Educated/reinforce patient training in subcutaneous self-administration technique. Confirm patient has an adequate supply of
interferon for the next cycle of therapy.
Follow-Up
DAY 15 FOLLOW-UP
LABS: CBC, ANC (DIFF if done locally).
DAY 29 FOLLOW-UP
(Day 1 of next cycle) RETURN TO CLINIC for appointment with provider; LABS: CBC, ANC (DIFF if done locally), Creatinine;
CHEMOTHERAPY ROOM appointment for interferon alfa-2B SC injection for 30 minutes.
Lab Only - Day 15, Cycle 4 – Planned for 9/21/2017
Treatment Plan Information
Treatment Plan Summary
DISEASE: Renal Cancer (Adjuvant/Advanced); THERAPY: interferon alfa-2B 5 to 10 million units/m2 subcutaneous 3 times per
week; CYCLE LENGTH: 28 days; COURSE: 6 cycles or until disease progression.
IV Access
Insert and Maintain Peripheral IV
CONTINUOUS Starting when released Until Specified
Peripheral IV Size: RN Discretion
Additional PIV may be inserted as needed for repeat blood sampling or IV medication administration.
Pre-Labs
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Zztestonc,Jeff J [2507481]
6/15/2017 7:59:44 AM Page 6 of 9
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
06/2017CCKM@uwhealth.org

CBC WITHOUT DIFFERENTIAL
Expected-S+14 Approximate, Expires-S+365, Routine
ABSOLUTE NEUTROPHIL COUNT
Expected-S+14 Approximate, Expires-S+365, Routine
Follow-Up
VERIFY APPOINTMENTS
Verify next day appointment(s) have been scheduled. See follow-up section on Day 1.
Cycle 5 – 10/5/2017 through 11/1/2017 (28 days), Planned
Day 1, Cycle 5 – Planned for 10/5/2017
Treatment Plan Information
Reference Information (1)
RENAL CANCER: Quesada JR, et al. J Clin Oncol 1985;3:1522-8.
Reference Information (2)
RENAL CANCER: Muss HB, et al. J Clin Oncol 1987;5:286-91.
Reference Information (3)
RENAL CANCER: Flanigan RC, et al. N Engl J Med 2001;345:1655-9
Reference Information (4)
RENAL CANCER: Mickisch GHJ, et al. Lancet 2001;358:966-70.
Treatment Plan Summary
DISEASE: Renal Cancer (Adjuvant/Advanced); THERAPY: interferon alfa-2B 5 to 10 million units/m2 subcutaneous 3 times per
week; CYCLE LENGTH: 28 days; COURSE: 6 cycles or until disease progression.
Consent
Verify Consent
Verify informed consent has been obtained.
IV Access
Insert and Maintain Peripheral IV
CONTINUOUS Starting when released Until Specified
Peripheral IV Size: RN Discretion
Additional PIV may be inserted as needed for repeat blood sampling or IV medication administration.
Pre-Labs
CBC WITHOUT DIFFERENTIAL
Expected-S+28 Approximate, Expires-S+365, Routine
ABSOLUTE NEUTROPHIL COUNT
Expected-S+28 Approximate, Expires-S+365, Routine
CREATININE
Expected-S+28 Approximate, Expires-S+365, Routine
Treatment Conditions
Verify Labs
Verify pretreatment labs have been obtained: CBC, ANC.
Treatment Parameters
Hold and notify authorizing prescriber for ANC less than or equal to 1,000/µL or Platelets less than or equal to 75K/µL.
Nursing Procedure, Assessment and Monitoring
Patient Instructions
Educated/reinforce patient training in subcutaneous self-administration technique. Confirm patient has an adequate supply of
interferon for the next cycle of therapy.
Follow-Up
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Zztestonc,Jeff J [2507481]
6/15/2017 7:59:44 AM Page 7 of 9
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
06/2017CCKM@uwhealth.org

DAY 15 FOLLOW-UP
LABS: CBC, ANC (DIFF if done locally).
DAY 29 FOLLOW-UP
(Day 1 of next cycle) RETURN TO CLINIC for appointment with provider; LABS: CBC, ANC (DIFF if done locally), Creatinine;
CHEMOTHERAPY ROOM appointment for interferon alfa-2B SC injection for 30 minutes.
Lab Only - Day 15, Cycle 5 – Planned for 10/19/2017
Treatment Plan Information
Treatment Plan Summary
DISEASE: Renal Cancer (Adjuvant/Advanced); THERAPY: interferon alfa-2B 5 to 10 million units/m2 subcutaneous 3 times per
week; CYCLE LENGTH: 28 days; COURSE: 6 cycles or until disease progression.
IV Access
Insert and Maintain Peripheral IV
CONTINUOUS Starting when released Until Specified
Peripheral IV Size: RN Discretion
Additional PIV may be inserted as needed for repeat blood sampling or IV medication administration.
Pre-Labs
CBC WITHOUT DIFFERENTIAL
Expected-S+14 Approximate, Expires-S+365, Routine
ABSOLUTE NEUTROPHIL COUNT
Expected-S+14 Approximate, Expires-S+365, Routine
Follow-Up
VERIFY APPOINTMENTS
Verify next day appointment(s) have been scheduled. See follow-up section on Day 1.
Cycle 6 – 11/2/2017 through 11/29/2017 (28 days), Planned
Day 1, Cycle 6 – Planned for 11/2/2017
Treatment Plan Information
Reference Information (1)
RENAL CANCER: Quesada JR, et al. J Clin Oncol 1985;3:1522-8.
Reference Information (2)
RENAL CANCER: Muss HB, et al. J Clin Oncol 1987;5:286-91.
Reference Information (3)
RENAL CANCER: Flanigan RC, et al. N Engl J Med 2001;345:1655-9
Reference Information (4)
RENAL CANCER: Mickisch GHJ, et al. Lancet 2001;358:966-70.
Treatment Plan Summary
DISEASE: Renal Cancer (Adjuvant/Advanced); THERAPY: interferon alfa-2B 5 to 10 million units/m2 subcutaneous 3 times per
week; CYCLE LENGTH: 28 days; COURSE: 6 cycles or until disease progression.
Consent
Verify Consent
Verify informed consent has been obtained.
IV Access
Insert and Maintain Peripheral IV
CONTINUOUS Starting when released Until Specified
Peripheral IV Size: RN Discretion
Additional PIV may be inserted as needed for repeat blood sampling or IV medication administration.
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Zztestonc,Jeff J [2507481]
6/15/2017 7:59:44 AM Page 8 of 9
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
06/2017CCKM@uwhealth.org

Pre-Labs
CBC WITHOUT DIFFERENTIAL
Expected-S+28 Approximate, Expires-S+365, Routine
ABSOLUTE NEUTROPHIL COUNT
Expected-S+28 Approximate, Expires-S+365, Routine
CREATININE
Expected-S+28 Approximate, Expires-S+365, Routine
Treatment Conditions
Verify Labs
Verify pretreatment labs have been obtained: CBC, ANC.
Treatment Parameters
Hold and notify authorizing prescriber for ANC less than or equal to 1,000/µL or Platelets less than or equal to 75K/µL.
Nursing Procedure, Assessment and Monitoring
Patient Instructions
Educated/reinforce patient training in subcutaneous self-administration technique. Confirm patient has an adequate supply of
interferon for the next cycle of therapy.
Follow-Up
DAY 15 FOLLOW-UP
LABS: CBC, ANC (DIFF if done locally).
DAY 29 FOLLOW-UP
(Day 1 of next cycle) RETURN TO CLINIC for appointment with provider; LABS: CBC, ANC (DIFF if done locally), Creatinine;
CHEMOTHERAPY ROOM appointment for interferon alfa-2B SC injection for 30 minutes.
Lab Only - Day 15, Cycle 6 – Planned for 11/16/2017
Treatment Plan Information
Treatment Plan Summary
DISEASE: Renal Cancer (Adjuvant/Advanced); THERAPY: interferon alfa-2B 5 to 10 million units/m2 subcutaneous 3 times per
week; CYCLE LENGTH: 28 days; COURSE: 6 cycles or until disease progression.
IV Access
Insert and Maintain Peripheral IV
CONTINUOUS Starting when released Until Specified
Peripheral IV Size: RN Discretion
Additional PIV may be inserted as needed for repeat blood sampling or IV medication administration.
Pre-Labs
CBC WITHOUT DIFFERENTIAL
Expected-S+14 Approximate, Expires-S+365, Routine
ABSOLUTE NEUTROPHIL COUNT
Expected-S+14 Approximate, Expires-S+365, Routine
Follow-Up
VERIFY APPOINTMENTS
Verify next day appointment(s) have been scheduled. See follow-up section on Day 1.
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Zztestonc,Jeff J [2507481]
6/15/2017 7:59:44 AM Page 9 of 9
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
06/2017CCKM@uwhealth.org